TY  - BOOK
AU  - Crichlow, Candace
AU  - Hahn, Laura S
AU  - Havistin, Ruby
AU  - Mahajan, Anshul
AU  - Mugmon, Marc
AU  - Orgeron, Gabriela M
AU  - Sekhsaria, Sudhir
AU  - Wang, John
TI  - Prevalence and management of aspirin hypersensitivity in a cardiology practice
SN  - 1088-5412
PY  - 2020///
KW  - *Allergens/ae [Adverse Effects]
KW  - *Aspirin/ae [Adverse Effects]
KW  - *Coronary Disease/ep [Epidemiology]
KW  - *Drug Hypersensitivity/ep [Epidemiology]
KW  - *Percutaneous Coronary Intervention
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Allergens/im [Immunology]
KW  - Aspirin/tu [Therapeutic Use]
KW  - Coronary Disease/di [Diagnosis]
KW  - Diagnostic Errors/pc [Prevention & Control]
KW  - Drug Hypersensitivity/di [Diagnosis]
KW  - Electronic Health Records
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prevalence
KW  - Retrospective Studies
KW  - United States/ep [Epidemiology]
KW  - Young Adult
KW  - MedStar Union Memorial Hospital
KW  - Journal Article
KW  - Research Support, Non-U.S. Gov't
N2  - Background: Data are lacking with concern to the prevalence and management of aspirin (ASA) hypersensitivity. Objective: To study the prevalence, different types of reactions, and implications for clinical management of ASA hypersensitivity in a cardiology practice. Methods: We conducted an electronic medical record review of 11,375 individuals, 5052 (44%) in the ambulatory setting, and 6323 (56%) admitted for percutaneous coronary intervention (PCI), from January 2012 to December 2013. Results: The prevalence of ASA hypersensitivity was 1.88% (n = 214). Skin reactions were the most common (40 [19%]), followed by angioedema (10 [4.6%]), respiratory (9 [4.2%]), and anaphylaxis (6 [2.8%]). No records were found for 74 patients (34.5%), and 69 patients (32.2%) were mistakenly labeled as allergic for having gastrointestinal symptoms. Of the 214 patients who had documented ASA hypersensitivity, 108 individuals (50.46%) had coronary artery disease. The medications at discharge were the following: ASA (30 [14%]), thienopyridine (48 [22%]), a combination of ASA and thienopyridine (13 [6%]), anticoagulation only (26 [12%]), and no antiplatelet (97 [43%]). Conclusion:  ASA hypersensitivity is often not documented correctly or is often misdiagnosed or not appropriately managed. There is a need for improved management of ASA hypersensitivity, including appropriate referral for ASA desensitization and combating unnecessary avoidance in patients with intolerance due to adverse effects
UR  - https://dx.doi.org/10.2500/aap.2020.41.190032
ER  -